Individual
TONY J TITAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8150 LAKECREST DR APT 319, GREENBELT, MD 20770-3324
(915) 200-9824
Mailing address
8150 LAKECREST DR, GREENBELT, MD 20770-3334
(915) 200-9824
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/17/2023
Last updated
04/16/2024
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